Hydrocortisone 5 mg / cinchocaine hydrochloride 5 mg suppositories
Each suppository contains:
Hydrocortisone 5 mg and cinchocaine hydrochloride 5 mg
For the full list of excipients, see section 6.1.
An off-white, odourless, smooth, suppositories.
Uniroid-HC Suppositories are indicated for use in the treatment of internal haemorrhoids for the short term relief of pain, irritation and associated pruritus ani.
Treatment with Uniroid-HC Suppositories should be limited to seven days. Patients should be advised to return to their doctor if the condition persists beyond this time.
Directions for use and dosage schedule:
Peel away the foil and insert a suppository as far as possible into the anus.
One suppository to be inserted twice a day (morning and evening) and after each bowel movement, or as prescribed by the doctor.
The suppositories may be used separately or concurrently with the ointment.
Dosage modifications are not required in the elderly.
Uniroid-HC Suppositories are not recommended for use in children under 12 years of age unless directed by a doctor.
Method of administration
For rectal use only
Hypersensitivity to the active substances or to any of the excipients listed in section 6.1.
This product is contraindicated in tuberculosis, anal thrush and most viral lesions of the skin including herpes simplex, vaccinia and varicella.
Recurrent or prolonged application may increase the risk of contact sensitisation particularly to cinchocaine.
As with all preparations containing topical steroids, the possibility of systemic absorption should be considered. In particular, long-term continuous therapy should be avoided in infants. Adrenal suppression can occur even without occlusion.
Visual disturbance may be reported with systemic and topical corticosteroid use. If a patient presents with symptoms such as blurred vision or other visual disturbances, the patient should be considered for referral to an ophthalmologist for evaluation of possible causes which may include cataract, glaucoma or rare diseases such as central serous chorioretinopathy (CSCR).
Co-treatment with CYP3A inhibitors, including cobicistat-containing medicinal products, is expected to increase the risk of systemic side-effects.
The combination should be avoided unless the benefit outweighs the increased risk of systemic corticosteroid side-effects, in which case patients should be monitored for systemic corticosteroid side-effects.
In pregnant animals, administration of corticosteroids can cause abnormalities of foetal development. The relevance of this finding to human beings has not been established. However, topical steroids should not be used extensively in pregnancy, i.e. in large amounts or for long periods.
Hydrocortisone may pass into human breast milk. Given the possible maternal systemic absorption and lack of data, Uniroid-HC Suppositories should preferably not be used during lactation unless the potential benefits to the mother outweigh the potential risks, including those to the breastfed child.
Uniroid-HC Suppositories have no or negligible influence on the ability to drive and use machines.
The frequencies of adverse events are ranked according to the following convention: very common (≥1/10), common (≥1/100 to <1/10), uncommon (≥1/1,000 to <1/100), rare (≥1/10,000 to <1/1,000), very rare (<1/10,000), not known (cannot be estimated from the available data).
Not known: Adrenal suppression (see section 4.4).
Not known: Chorioretinopathy, vision blurred (see section 4.4).
Not known: Anorectal discomfort.
Skin and subcutaneous tissue disorders
Not known: Urticaria, rash (see section 4.4).
Reporting of suspected adverse reactions
Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via the Yellow Card Scheme Website: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store.
Not applicable to a product with this route of administration.
Pharmacotherapeutic group: Agents for treatment of haemorrhoids and anal fissures for topical use - corticosteroids
ATC code: C 05 AA 01.
The principle pharmacological actions of hydrocortisone are on gluconeogensis, glycogen deposition, protein and calcium metabolism and inhibition of corticotrophin secretion and anti-inflammatory activity (glucocorticoid actions). When applied topically hydrocortisone causes reduction of inflammation, pruritus and exudation in disorders of the skin and perianal region.
Cinchocaine hydrochloride is a local anaesthetic agent and is suitable for surface or spinal anaesthesia and for relaxing sphincteric spasms. It is an anaesthetic of the amide type. It is more toxic than cocaine by local application, but its local anaesthetic action is greater, so it can be used in lower concentrations. Its action is more prolonged than lignocaine.
Surface or topical anaesthetics such as cinchocaine block the sensory nerve endings in the skin preventing transmissions of impulses along the nerve fibres and inhibiting depolarisation and ion-exchange. These effects are reversible. Before this blocking action can occur the lipid, soluble anaesthetic base must penetrate the lipoprotein nerve sheath and the effectiveness of the anaesthetic depends on the concentration attained in the nerve fibre. The onset of action varies depending on the anaesthetic used. Cinchocaine has a rapid onset of action and is also long lasting.
Hydrocortisone is passed through the skin, particularly in denuded areas. About 90% of plasma hydrocortisone is bound to plasma proteins, mainly to globulin, less so to albumin. In the liver and most body tissues it is metabolised to hydrogenated and degraded forms such as tetrahydrocortisone and tetrahydrocortisol. These degraded forms are excreted in the urine. They are mainly conjugated as glucuronides. A very small proportion of unchanged hydrocortisone is excreted in the urine.
Most local anaesthetics such as cinchocaine hydrochloride are absorbed through damaged skin. Cinchocaine hydrochloride is an ester-type local anaesthetic. Following absorption, it is hydrolysed by esterases in the plasma and liver.
There are no pre-clinical data of relevance to the prescriber which are additional to that already included in other sections of the SPC.
Adeps Solidus (Witepsol H15) Ph. Eur.
Do not store above 25°C. Store in the original package.
Printed Aluminium Foil.
The product is available in packs of 10 and 12 suppositories.
Not all pack sizes may be marketed.
Chemidex Pharma Limited
Egham Business Village
Surrey TW20 8RB
3 November 2000/ 5 March 2004